Medicare Secondary Payment Bill Passes Through Congress

Congress has passed legislation sought by the insurance industry and other stakeholders since late 2008 that streamlines enforcement of the Medicare Secondary Payment program.

David Farber, a lawyer for the Medicare Advocacy Recovery Coalition (MARC), and a partner at Patton Boggs, in Washington, D.C., says passage of legislation produces “wins for Medicare beneficiaries, the Medicare Trust Fund and businesses resolving claims.”

The Senate completed action Friday night on the bill, passing it through unanimous consent as Title II of H.R. 1845, legislation that provides for a study on issues relating to access to intravenous immune globulin (IVIG) for Medicare beneficiaries.

The House passed the bill under suspension of the rules earlier last week.

The legislation is H.R. 1063, the SMART Act, or The Strengthening Medicare and Repaying Taxpayers Act.

It addresses flaws in legislation passed hurriedly in 2007 that mandated the Medicare program do a better job of recovering funds paid out for medical care of people who later get paid for settlements from insurance companies.

The SMART Act seeks to ease the burdensome compliance requirements for the 2007 legislation, making it easier for insurers to repay Medicare, industry officials say.

“This is a major victory for the property and casualty industry,” says Tom Litjen, vice president of federal government relations for the Property Casualty Insurers Association of America.

“Medicare beneficiaries, taxpayers, and insurers will all benefit from the improvements in the reporting requirements in the Medicare Secondary Payer system,” Litjen adds.

Jimi Grande, senior vice president, federal & political affairs for the National Association of Mutual Insurance Companies, says passage of the SMART Act will help create a clear set of rules to help ensure swift settlements of claims and reduce waste and fraud costs for the Medicare Trust.

“The bill had strong bipartisan support, and NAMIC applauds both chambers for taking up the bill and passing it,” Grande states. “The SMART Act helps consumers and insurers by clarifying a confusing system, and it reduces costs to the Medicare Trust Fund as well, a claim few other bills can make.”

Mary Alice McLarty, president of the American Association for Justice, which represents trial lawyers, says “This bipartisan legislation is a practical solution that will streamline the Medicare Secondary Payer system to ensure that seniors and persons with disabilities get timely assistance and taxpayers are repaid millions of dollars every year.”

McLarty calls the legislation “a big step forward and is the result of senior advocates, the legal community and the business community coming together to work out a common sense solution.”

McLarty adds, “There is still work to be done. To ensure this legislation has the most impact, CMS must eliminate confusion and uncertainty by providing clear, efficient and definitive information to seniors.”